Toenail as Non-invasive Biomarker in Metal Toxicity Measurement of Welding Fumes Exposure - A Review

Workers are exposed to a variety of heavy metal pollutants that are released into the environment as a consequence of workplace activities. This chemical pollutants are incorporated into the human by varies of routes entry and can then be stored and distributed in different tissues, consequently have a potential to lead an adverse health effects and/or diseases. As to minimize the impact, a control measures should be taken to avoid these effects and human biological marker is a very effective tool in the assessment of occupational exposure and potential related risk as the results is normally accurate and reproducible. Toenail is the ideal matrix for most common heavy metals due to its reliability and practicality compared to other biological samples as well as it is a non-invasive and this appears as a huge advantage of toenail as a biomarker. This paper reviews studies that measure the heavy metals concentration in toenail as non-invasive matrix which later may adapt in the investigation of metal fume emitted from welding process. The development of new methodology and modern analytical techniques has allowed the use of toenail as non-invasive approach. The presence of a heavy metal in this matrix reflects an exposure but the correlations between heavy metal levels in the toenail must be established to ensure that these levels are related to the total body burden. These findings suggest that further studies on interactions of these heavy metals in metal fumes utilizing toenail biomarker endpoints are highly warranted especially among welders.